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33 Cards in this Set
- Front
- Back
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What is the MOA of Penicillins?
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Bactericidal - only against actively growing organisms
Interfere w/ cell wall synthesis |
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How does PEN interfere w/ cell wall synthesis?
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- PBPs: accumulate in periplasmic space
- inhibit traspeptidases (normally catalyzes cross-linking b/t peptidoglycans - stimulate autolysins (normally remodel cell wall when needed): work when not needed --> damage to cell wall |
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What are the two 1st generation PEN? And what is unique about them?
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- PEN G & V
- required higher dosage b/c beta-lactamase sensitive |
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What are the 2nd generation PEN (6)?
What's unique to each drug? |
-beta-lactamase resistant
Methicillin - very toxic Dicloxacillin - skin infection Oxacillin & cloxacillin - skin infection Nafcillin - eliminated via biliary route Flucloxacillin - serious infections |
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What are the broad spectrum PEN (3rd gen)? Why unique?
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- target GRAM + & -
(mixed w/ beta-lactamase inhibitors) Ampicillin: Listeria species Amoxicillin: many bacterial infections (cardiac prophylaxis for dental work) |
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What are the 2 beta-lactamase inhibitors?
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- Clavulanic acid
- Sulbactam |
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What are the extended spectrum PEN (4th gen)? Why unique?
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- "anti-pseudomonal"
Carbenicillin Piperacillin Ticarcillin |
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How do you tx Pseudomonas?
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Anti-pseudomonal PEN & (AG or Cipro)
**Never monotherapy** |
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What are some SE of PEN?
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- allergic rxn --> anaphylaxis
(maculopapular rash - angioedema) - diarrhea - nephritis - neurotoxicity w/ seizures |
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How are PEN excreted?
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Renally
(except nafcillin) |
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How do bacteria express beta-lactamase activity?
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-must have the gene for it
(acquired) -carried in a plasmid |
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Does PEN cross placenta?
Teratogenic? |
Crosses placenta but NOT teratogenic
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If pt can't take PEN, what is usually given?
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Erythromycin (macrolide)
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What is the 1st generation Cephalosporin?
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Cefazolin
- DOC for skin & bone infections |
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What is the 1st gen cephalosporin special sensitivity?
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PEcK
Proteus E. coli Klebsiella (Plus gram +) |
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What are the 2nd gen cephalosporins?
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Cefamandole
Cefoxitin Cefuroxime Cefotetan |
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What are 2nd gen CS active against?
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more G -
many G + |
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What is 1st gen CS active against?
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some G -
MANY G + |
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What are the special sensitivities for the 2nd gen CS?
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H. influenza
Enterobacter aerogenes Neisseria Proteus E. coli Klebsiella |
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What are the 3rd gen CS?
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Ceftazidime
Cefotaxime Ceftriaxone Cefoperazone Ceftizoxime |
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What are 3rd gen CS active against?
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MANY G -
many G + |
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What are the special sensitivities of 3rd gen CS?
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H. influenzae
Enterobacter aerogenes Neisseria Proteus E. coli Klebsiella (Plus enterics) |
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What are the 4th gen CS?
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Cefepime
Cefpirome |
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What are 4th gen CS active against?
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Pseudomonas aeruginosa
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What is unique about Cefamandole?
(why should we know when we don't use in the US?) |
Use in other places in the world
- causes disulfiram-like rxn when taken w/ alcohol |
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What other CS can cause disulfiram-like rxn?
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Cefotetan
Cefoperazone |
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What is the MOA of a disulfiram rxn?
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Inhibition of aldehyde DH
--> build-up acetaldehyde |
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What are the s/s disulfiram rxn?
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Flushing
Tachycardia Hyperventilation N/V Palpitations CP Hypotension |
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What are some other drugs that can cause disulfiram rxns?
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Metronidazole
Chloramphenicol Isoniazid Nitrofurantoin Sulfamethoxazole Sulfisoxazole Cefoperazone Cefotetan Cefamanadole Griseofulvin Disulfiram (Antabuse) Nitroglycerin Isosorbide dinitrate tolbutamide Chlorpropamide Glyburide Glipizide Tolazamide Quinacrine Toxic mushrooms |
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What cephalosporin crosses the BBB?
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Cefuroxime
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What cephalosporin is very active against anaerobic organisms?
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Cefoxitin
used in PID & intra-abdominal infections |
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How are most CS eliminated?
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Renally
(except Ceftriaxone - via bile) also is the DOC for N. gonorrhea |
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Which 3rd gen CS active against Pseudomonas aeruginosa?
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Ceftazidime
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